Individual provider · NPI-1

Kelly C Acevedo, RN, MSN, GNP

Nurse Practitioner, Gerontology · Charlotte, NC

NPI number1497886956
StatusActive
Last updated in NPPESJun 18, 2013

Details

NPI
1497886956
Entity type
Individual (NPI-1)
Name
Ms. Kelly C Acevedo
Credential
RN, MSN, GNP
Sex
Female
Sole proprietor
No
Enumeration date
Mar 8, 2007
Last updated
Jun 18, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LG0600X Nurse Practitioner, Gerontology249757NCYes
163WG0600X Registered Nurse, Gerontology2854SC
363LG0600X Nurse Practitioner, Gerontology2854SC

Practice location

1000 Blythe Blvd
Charlotte, NC 28203-5812

Phone 704-512-5363 · Fax 704-512-2428

Mailing address

Po Box 602148
Charlotte, NC 28260-2148

Phone 704-512-5363 · Fax 704-512-2428

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